Individual provider Active NPI

Nivia Esther Vazquez, MD

  • Pediatrics Physician
  • Homestead, FL
National Provider Identifier
1063453124
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME64580 Issued in FL
Practice address
925 NE 30TH Ter, Ste 202
Homestead, FL 33033-7614
Phone
(305) 246-1030
Fax
(305) 246-2387
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME64580 FL Primary

Addresses

Primary practice location

925 NE 30TH Ter, Ste 202
Homestead, FL 33033-7614

Mailing address

925 NE 30TH Ter, Ste 202
Homestead, FL 33033-7614
Phone (305) 246-1030

Other identifiers 2

IdentifierTypeStateIssuer
23935ZOtherFLPTAN MEDICARE PART B PROGRAM
374045500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nvazquez@pedinet.direct.emds.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110718000415 FL Practitioner - Pediatric Medicine 7012195316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME64580FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nivia E. Vazquez, M.D.,P.a. Pediatrics CurrentSince May 28, 2011 Accepting new patients

Locations

925 NE 30th Ter
Ste 202
Homestead, FL 33033
Phone (305) 246-1030

Interoperability endpoints

  • Direct secure messaging: nvazquez@pedinet.direct.emds.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1063453124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 NE 30TH TER, STE 202",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337614",
            "telephone_number": "305-246-1030",
            "fax_number": "305-246-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 NE 30TH TER, STE 202",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337614",
            "telephone_number": "305-246-1030",
            "fax_number": "305-246-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "NIVIA",
        "middle_name": "ESTHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME64580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN MEDICARE PART B PROGRAM",
            "identifier": "23935Z",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374045500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nvazquez@pedinet.direct.emds.com",
            "affiliation": "N",
            "address_1": "925 NE 30TH TER, STE 202",
            "city": "HOMESTEAD",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330337614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.